This column appeared in the Colorado Springs Gazette. To syndicate the national version, contact DrHubbard [at] TheSurvivalDoctor [dot] com.

by James Hubbard, MD, MPH

If you get burned it’s usually a pretty simple matter to get medical help. That is, unless you’re out camping, or a storm has the roads closed. Then what do you do?

No matter where you are, know the first step: Cool the burn. This soothes the pain and stops the damage in its tracks.

Immediately take off any burned clothes. Even when cooled with water, many synthetics continue to be hot enough to burn skin.

Next, apply cool water or aloe vera. Don’t use ice. It constricts blood flow. Never initially use greasy substances like butter or ointments, unless there’s hot tar or glue stuck to your skin. Petroleum jelly can help get those off.

OK, what next?

In general, with large burns that involve the face or neck you should get to a doctor ASAP, even that means an airlift, because of potential swelling of the airways. Of course, do the same for extensive burns that involve large areas of the skin.

But what about the smaller ones—the ones that are bad but not immediately life threatening? There are three common complications to worry about after a burn.

1. Pain. Cooling the area, applying aloe vera and using over-the-counter pain medications can control pain from most first-degree (sunburn-like) burns. But if the pain is too much, you’ll have to get that professional help sooner than later.

2. Swelling. Along with the danger of life-threatening swelling to the face or neck if you get burned in that area, there’s the danger of a tourniquet effect from a burn that encircles an arm or leg if it swells enough to cut off circulation. Swelling is also the reason you should remove rings or other constrictive jewelry or clothes right away.

Applying cool compresses on the injured area and elevating a burned extremity to your heart level or higher can help decrease the swelling.

With larger second- or third-degree burns—say 10 percent or more of your skin (your palm equals about 1 percent of your skin surface area)—the burns can cause so much swelling that you become severely dehydrated. You need a lot of IV fluids ASAP.

3. Infection. Anytime there’s a crack in the skin, infection becomes a possibility. The more skin surface is involved and the deeper the damage, the higher the risk. Keep all burns clean with soap and water.

Blisters are the calling cards of second-degree burns. The ones that stay intact act as sterile dressings and help the burn heal. But if they start leaking, infection becomes a risk.

As a general rule, blisters an inch or more in diameter, or that are on a hand, are more likely to start leaking. If you can’t get to a doctor soon, consider puncturing these and cutting away the dead skin. (Use sterile instruments.) Then keep the area clean, and apply antibacterial ointment.

Now for the biggies.

Third-degree burns damage all skin layers, including the layer that regenerates your skin. The only way these can heal is for the uninjured skin edges to grow over the area. This takes a while, and the skin can only grow over about an inch or two. Until you can get expert help, keep the wound clean, and apply antibiotic ointment. If the burn is more than a couple of inches, you’ll likely need a skin graft.

Remember, these tips are for only until you can get professional medical help. Get that as soon as you can.

Colorado Springs family doctor James Hubbard teaches how to survive when you can’t get to a doctor at, one of the most popular survival websites. Dr. Hubbard is the author of the best-selling e-books
The Survival Doctor’s Guide to Wounds and The Survival Doctor’s Guide to Burns.